Obstetric history and examination Flashcards

1
Q

What are the subsections of an obstetric history?

A

Personal details; presenting complaint/present circumstances; history of present pregnancy; past obstetric history; systems review

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2
Q

What would you ask about the history of the present pregnancy?

A

Dates: LMP? length of menstrual cycle? regular menstrual cycle? how many weeks pregnant? EDD (expected delivery date)
Complications of pregnancy: bleeding? HTN? diabetes? anaemia? UTI? concerns about fetal growth? any hospital admissions?
Tests: US scans? blood tests? prenatal diagnostic tests?

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3
Q

How would you estimate gestational age?

A

From first day of LMP, allowing for cycle length:
1. Measurement of crown-rump length between 9-14 weeks
2. Head circumference between 14 and 20 weeks if no early scan and LMP unknown.
Gestational age calculations are inaccurate after 20 weeks

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4
Q

What would you ask about the past obstetric history?

A

Mode and gestation of delivery, if operative, why? FBW and sex? maternal or fetal complications? how many pregnancies? how many children?

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5
Q

What is gravida?

A

The number of times a woman has been pregnant

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6
Q

What is parity?

A

The number of viable pregnancies a woman has had (over 24 weeks)

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7
Q

What would you ask in the systems review of an obstetric history?

A

Past gynae: date and result of last cervical smear? any abnormal smears? any difficulties conceiving?
PMH: operations, heart disease. HTN, diabetes, psych problems, epilepsy
Drugs: at time of conception? currently?
FH: twins, diabetes, HTN, PE, autoimmune disease, DVT, thrombophilia
Social: smoke? alcohol? social support?
Allergies: penicillin? latex?

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8
Q

Why do you check the abdomen at <24 weeks; >24 weeks; >36 weeks?

A

<24 weeks: to check dates, twins
>24 weeks: assess well-being, size and liquor
>36 weeks: to check lie, presentation and engagement

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9
Q

Why do you palpate a pregnant abdomen?

A

Is the fetus adequately grown? is the liquor volume normal? is the lie longitudinal? is the presentation cephalic and, if so, is it engaged?

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